Last time, I wrote about what the research says regarding coping after brain injury. This week, I want to analyze how well this research dovetails with a real-world example (mine).
The American Psychological Association defines coping as “the use of cognitive and behavioral strategies to manage the demands of a situation when these are appraised as taxing or exceeding one’s resources or to reduce the negative emotions and conflict caused by stress.”
As I noted last time, Cardile et al. wrote, “Research has shown that patients with ABI who use active coping strategies and are problem-oriented face the disease with greater resilience and a sense of self-efficacy and report fewer symptoms.” Sasse et al. in 2014 divided coping strategies into adaptive action/distraction versus maladaptive trivialization/resignation. Bryant et al. in 2000 identified avoidance as a maladaptive coping strategy.
By damaging affect, emotional control, and cognitions, brain injury drastically reduces one’s resources and access to active coping strategies.
I faced this reality after my brain injury. Yet according to the research, my resilient approach of facing my problems, seeking to understand them instead of trivializing and avoiding, and persistently looking for solutions aligned with better coping.
Pre-Injury Coping Strategy
My neurorehab stress management course determined that my top coping strategy prior to my brain injury was reading. Unfortunately, the injury destroyed it. Reading contains elements of distraction—escaping reality into another world—and action, e.g., accumulating knowledge about one’s injury and learning what others do to cope, heal, and reintegrate into society. Any strategy that allows one to enter flow—a state I lost after brain injury—intrinsically rewards and contains elements of action and distraction. But what happens when your injury eliminates automaticity, long-held skills, and cognitions like memory and concentration? You can’t enter flow. And you end up using coping strategies that require no skills and no ability to retain habits.
That’s what happened to me.
Post-Injury Maladaptive Coping
I fell back on the one coping strategy I could use: eating—specifically, organic dark chocolate—whenever I was in physical or psychological pain.
Eating, though, is maladaptive. Unlike reading or television, which can distract for hours, eating distracts only momentarily, necessitating repetition, which worsens health.
Challenges With Diet, Stress, and Weight
My GP diagnosed me with diabetes in 2009 and prescribed a low-glycemic diet. I had been eating the low-glycemic way before my brain injury but had forgotten about it, and no one in my life reminded me.
An adaptive coping personality does not compensate for a brain that requires others to fill in functional gaps. Yet lacking are standardized professional responses to helping an isolated patient replace maladaptive coping strategies with realistic ones that are doable within a person’s injury-created limitations and to buttress effective coping strategies regularly.
My GP referred me to a physical trainer familiar with heart issues in concussed elite athletes. This person modified my diet further and developed an individualized exercise regimen that led to me no longer retaining water and not having to sleep with my head elevated. The trainer had me provide regular feedback and didn’t sugarcoat diet advice. Too often, I forgot advice because the healthcare professional would provide it once, not bluntly enough, and not to any of my team—assuming that since I’m strong, I don’t need reminding or support to act on it. The trainer didn’t make that mistake.
However, after my time with the trainer ended, my injured brain combined with my never-ending high stress levels meant I struggled to keep my weight off. Being able to bake easier, without needing Post-it notes plastered on my cabinets to remind me of each step, exacerbated the situation. On the one hand, baking distracted me and reinforced cognitions; on the other, I had few to share it with. Hiding cookies and brownies in the freezer doesn’t keep them out of my mouth. Watching shows worked better as a distraction strategy that aligned with my neuro-fatigue, which my parents recognized when they insisted I buy a TV for my bedroom. But it was neither productive nor life-affirming.
Regaining Skills and Adaptive Strategies
Over the years, through neurostimulation and neuromodulation treatments, I regained my reading, memory, concentration, writing, and other skills to the extent that, with healthcare support, I can use reading to lessen negative emotions and sympathetic overdrive, and writing and computer work now distract me after next-gen treatments restored flow somewhat, if only for a few minutes.
When my health improved enough about three to four years into the pandemic, my GP and pain specialist prescribed walking five days per week to manage my diabetes and stress. They increased the time very gradually. They are both strict in ensuring I keep it up; my case manager checks in on my walking every so often. Walking, writing, and reading as adaptive coping strategies partially replace eating now because I healed enough through next-gen treatments and have professional support. When the support wanes over holidays, and I’m tired of being tired, I skip a walk or two and write and read less.
I’m experimenting with how to use reading, writing, distraction, and other life-affirming techniques to stop defaulting to the eating strategy and to use only a small treat to reward accomplishing difficult tasks. Since 2000, I’ve not had a robust conversation about replacing eating with a coping strategy my brain injury will allow. Instead, I’ve had sporadic conversations about my weight and diet. Discussing eating in the context of weight, diet, and exercise is not the same as discussing it in the context of coping with overwhelming situations and emotions. In the absence of a robust approach, eating chocolate or cookies is easier.
At the end of the day, the research misses two crucial points that led to my weight gain, despite my adaptive personality traits and knowledge of active strategies. Unhealed brain injury leads to maladaptive coping strategies by eliminating or preventing healthy skills. And no coping strategy can substitute for a person or inclusive community willing to come alongside and metaphorically carry you when circumstances overwhelm an injured brain.
Copyright ©2026 Shireen Anne Jeejeebhoy
